SHORT-TERM TREATMENT OUTCOME STUDY FOR THE MANAGEMENT OF TEMPOROMANDIBULAR-JOINT CLOSED LOCK - A COMPARISON OF ARTHROCENTESIS TO NONSURGICAL THERAPY AND ARTHROSCOPIC LYSIS AND LAVAGE

Objective. The aim of this study is to compare the clinical short-term results and efficacy of arthrocentesis with those of nonsurgical trea tments and arthroscopic surgery for the management of temporomandibula r joint closed lock. Study Design. The three groups consisted of 63 co nsecutive patients treated nonsurgically, 20 patients treated with art hrocentesis, and 25 patients treated with arthroscopic surgery. All pa tients rated their pain level on a visual analogue scale and completed a pain, jaw dysfunction, and activity-limiting questionnaire before a nd 6 months after the procedure. Each patient's jaw opening was also s caled. The success rate of each procedure was calculated according to our success criteria. The clinical efficacy of each procedure was eval uated in successfully treated subgroups in which the between-group and within-group differences of the obtained data were statistically test ed: Results. The success rate was 55.6% in the nonsurgically treated g roup, 70% in the arthrocentesis group, and 91% in the arthroscopy grou p. With respect to efficacy, all posttreatment scores showed significa nt improvements in within-group differences, but no between-group diff erences were found between the arthrocentesis group and the other two groups. Conclusion. Arthrocentesis was considered as an intervening tr eatment modality between nonsurgical treatment and arthroscopic surger y on the basis of its short-term outcome Although the treatment effica cy was comparable with arthroscopic surgery, this procedure was though t to be indicated for the patients with acute temporomandibular joint closed lock who were refractory to medication and mandibular manipulat ion rather than the alternative of arthroscopic surgery.